6,271 results match your criteria Canadian journal of surgery. Journal canadien de chirurgie[Journal]


Deployment of second-generation resuscitative endovascular balloon occlusion of the aorta for unresponsive hypotension in a polytrauma patient

Can J Surg 2019 Apr;62(2):142-144

From the Faculty of Medicine McGill University, Montreal, Que. (Paradis); the Trauma Program, McGill University Health Centre, Montreal, Que, (Bekdache, Bracco, Grushka, Razek, Lasry, Beckett); and the Royal Canadian Medical Services, Montreal, Que. (Beckett).

Summary: Noncompressible hemorrhagic control remains one of the most challenging areas in damage control medicine and continues to be a leading cause of preventable death. For decades, emergency thoracotomy or laparotomy and aortic cross clamping have remained the gold standard intervention. Recently, there has been a movement toward less invasive techniques for noncompressible hemorrhagic control, such as resuscitative endovascular balloon occlusion of the aorta (REBOA). Read More

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http://dx.doi.org/10.1503/cjs.007618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440891PMC
April 2019
1 Read

Laparoscopic colectomy: trends in implementation in Canada and globally

Can J Surg 2019 Apr;62(2):139-141

From the Division of General Surgery, Department of Surgery, Dalhousie University, Halifax, NS (Hoogerboord, Ellsmere); the Division of General Surgery, Department of Surgery, Northern Ontario School of Medicine, Sudbury, Ont. (Caycedo-Marulanda); the Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, BC (Brown); the Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Jayaraman, Urbach); the Department of Surgery, St. Joseph’s Health Centre, Toronto, Ont. (Jayaraman); the Department of Surgery, Women’s College Hospital, Toronto, Ont. (Urbach); and the Department of Surgery, Mayo Clinic, Rochester, MN (Cleary).

Summary: Comparisons with other high-income countries suggest that Canada has been slower to adopt laparoscopic colectomy (LC). The Canadian Association of General Surgeons sought to evaluate the barriers to adoption of laparoscopic colon surgery and to propose potential intervention strategies to enhance the use of the procedure. Given the clinical benefits of laparoscopic surgery for patients, the increasing needs for surgical care and the desire of Canadian general surgeons to advance their specialty and enhance the care of their patients, it is an important priority to improve the utilization of LC. Read More

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http://dx.doi.org/10.1503.cjs.003118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440892PMC
April 2019
1 Read

Effect of predicted travel time to trauma care on mortality in major trauma patients in Nova Scotia

Can J Surg 2019 Apr;62(2):123-130

From the Department of Surgery, Dalhousie University, Halifax, NS (Tansley); the Department of Geography, Simon Fraser University, Burnaby, BC (Schuurman); the Nova Scotia Medical Examiner Service, Dartmouth, NS (Bowes); Trauma Nova Scotia, Nova Scotia Department of Health and Wellness, Halifax, NS (Erdogan, Green); the Department of Critical Care, Dalhousie University, Halifax, NS (Green); the Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS (Asbridge); and the Department of Surgery, University of Calgary, Calgary, Alta. (Yanchar).

Background: Trauma is a leading contributor to the burden of disease in Canada, accounting for more than 15 000 deaths annually. Although caring for injured patients at designated trauma centres (TCs) is consistently associated with survival benefits, it is unclear how travel time to definitive care influences outcomes. Using a population-based sample of trauma patients, we studied the association between predicted travel time (PTT) to TCs and mortality for patients assigned to ground transport. Read More

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http://dx.doi.org/10.1503/cjs.004218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440889PMC

Does oxidized zirconium make a difference? Midterm cohort survivorship of symmetric posterior condyle posterior-stabilized total knee arthroplasty

Can J Surg 2019 Apr;62(2):118-122

From Kelowna Orthopedics, Kelowna, BC (Demcoe); and the Concordia Hip and Knee Institute, Division of Orthopaedic Surgery, University of Manitoba, Winnipeg, Man. (Bohm, Hedden, Burnell, Turgeon).

Background: A novel symmetric posterior condylar design and option of a femoral component with an outer zirconium oxide layer were introduced to a successful asymmetric condylar total knee arthroplasty system in 2005. Given the paucity of information on this modified design, we performed a study to determine its early to midterm survivorship and performance.

Methods: Patients who received the Genesis II Symmetric Posterior Condyle or Legion Primary total knee (cobalt–chromium [CoCr] or oxidized zirconium–niobium [OxZr]) (Smith & Nephew) implanted at the study centre between March 2007 and December 2013 were enrolled into a prospective database. Read More

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http://dx.doi.org/10.1503/cjs.007518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440896PMC

Surgical site infection following abdominal surgery: a prospective cohort study

Can J Surg 2019 Apr;62(2):111-117

From the Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Background: Surgical site infection (SSI) is one of the most common complications of abdominal surgery and is associated with substantial discomfort, morbidity and cost. The goal of this study was to describe the incidence, bacteriology and risk factors associated with SSI in patients undergoing abdominal surgery.

Methods: In this prospective cohort study, all patients aged 14 years or more undergoing abdominal surgery between Feb. Read More

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http://dx.doi.org/10.1503/cjs.004818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440888PMC
April 2019
1 Read

Prevalence of obstructive sleep apnea in male patients with surgically treated maxillary and zygomatic fractures

Can J Surg 2019 Apr;62(2):105-110

From the Department of Maxillofacial and Oral Surgery, University Hospital Center Split, Split, Croatia (Lupi-Ferandin); Dental Medicine Program, University of Split School of Medicine, Split, Croatia (Galic); the Split Sleep Medicine Center, University of Split School of Medicine, Split, Croatia (Ivkovic, Pecotic, Dogas); and the Department of Neuroscience, University of Split School of Medicine, Split, Croatia (Pecotic, Dogas).

Background: Midface fractures can cause airway obstruction and breathing disturbances. The purpose of the present study was to determine the prevalence of undiagnosed obstructive sleep apnea (OSA) among patients with surgically treated maxillary and zygomatic fractures.

Methods: We retrospectively analyzed the medical records of 44 patients who had undergone surgical treatment of maxillary or zygomatic fractures between Jan. Read More

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http://dx.doi.org/10.1503/cjs.002818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440884PMC
April 2019
9 Reads
1.267 Impact Factor

High-risk medications in older patients with trauma: a cross-sectional study of risk mitigation

Can J Surg 2019 Apr;62(2):100-104

From the Department of Surgery, University of Alberta, Edmonton, Alta.

Background: The Beers Criteria for Potentially Inappropriate Medication Use inOlder Adults is a framework that can assess the nature of high-risk medication use. The objective of this study was to use the Beers Criteria to assess the prevalence and nature of polypharmacy, the magnitude of medication changes during the hospital stay and the impact of Beers Criteria medications on outcomes in older patients with trauma.

Methods: We used the Alberta Trauma Registry to conduct a retrospective review of patients aged 65 years or older with major trauma (Injury Severity Score ≥ 12) who were admitted to a level 1 trauma centre between January 2013 and December 2014. Read More

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http://dx.doi.org/10.1503/cjs.017117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440890PMC

Predictors of dysplastic and neoplastic progression of Barrett’s esophagus

Can J Surg 2019 Apr;62(2):93-99

From the Department of General Surgery, McGill University Health Centre, Montreal, Que. (Alnasser); the Department of Epidemiology and Biostatistics – Cancer Epidemiology, McGill University, Montreal, Que. (Agnihotram, Franco); and the Ringgold Standard Institution – Gastroenterology, McGill University Health Centre, Montréal, Que. (Martel, Mayrand, Ferri).

Background: It is unknown why some cases of Barrett’s esophagus progress to invasive malignant disease rapidly while others do so more slowly or not at all. The aim of this study was to identify demographic and endoscopic factors that predict dysplastic and neoplastic progression in patients with Barrett’s esophagus.

Methods: Patients with Barrett’s esophagus who were assessed in 2000–2010 were assessed for inclusion in this retrospective study. Read More

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http://dx.doi.org/10.1503/cjs.008716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440887PMC
April 2019
1 Read

Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centre

Can J Surg 2019 Apr;62(2):83-92

From the Department of Surgery, McMaster University, Hamilton, Ont. (Li, Cornacchi, Farrokhyar, Forbes, Reid, Hodgson, Lucibello, Lovrics); the Department of Surgical Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, Ont. (Forbes, Rid, Hodgson, Lovrics); the Department of Surgery, St. Joseph’s Healthcare, Hamilton, Ont. (Lovrics); and the Department of Medicine, McMaster University, Hamilton, Ont. (Johnston).

Background:

Methods: Data from a single urban Canadian centre were collected for consecutive patients who received a diagnosis of breast cancer from January 2010 to December 2011. Variables included patient and disease factors, surgery type, systemic and radiation treatment, and breast reconstruction. Socioeconomic variables were obtained from 2006 Canadian census data. Read More

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http://dx.doi.org/10.1503/cjs.009217DOI Listing

Use of the Corail stem for revision total hip arthroplasty: evaluation of clinical outcomes and cost

Can J Surg 2019 Apr;62(2):78-82

From the Division of Orthopaedic Surgery, Department of Surgery, London Health Sciences Centre, University Campus, Western University, London, Ont. (Wood, Alzahrani, Vasarhelyi, Lanting); the Department of Orthopaedic Surgery, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (Alzahrani); the School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ont. (Marsh); and the Bone and Joint Institute, Western University, London, Ont. (Marsh, Vasarhelyi, Lanting).

Background: With the growing number of total hip arthroplasty (THA) procedures performed, revision surgery is also proportionately increasing, resulting in greater health care expenditures. The purpose of this study was to assess clinical outcomes and cost when using a collared, fully hydroxyapatite-coated primary femoral stem for revision THA compared to commonly used revision femoral stems.

Methods: We retrospectively identified patients who underwent revision THA with a primary stem between 2011 and 2016 and matched them on demographic variables and reason for revision to a similar cohort who underwent revision THA. Read More

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http://dx.doi.org/10.1503/cjs.002318DOI Listing
April 2019
2 Reads

Les revues de morbidité et mortalité sont-elles un art qui se perd?

Authors:
Chad G. Ball

Can J Surg 2019 Apr;62(2):77

Corédacteur en chef, Journal canadien de chirurgie

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http://dx.doi.org/10.1503/cjs.004519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440885PMC

Are morbidity and mortality conferences becoming a lost art?

Authors:
Chad G. Ball

Can J Surg 2019 Apr;62(2):76

Coeditor, Canadian Journal of Surgery

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http://dx.doi.org/10.1503/cjs.004119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440886PMC
April 2019
2 Reads

Decisional conflict in surgical patients: Should surgeons care?

Can J Surg 2019 Mar 22;62(3):1-3. Epub 2019 Mar 22.

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Roy, Novak, McCabe, Schroeder); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Roy, Urbach, Okrainec); the Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Urbach); and the Division of Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ont. (Okrainec).

Summary: Decisional conflict represents a state of uncertainty regarding an action one must take. It is a concept inherent to shared decision-making and can help promote high-quality and patient-centred decisions in surgical care, leading to better outcomes. Specific elements may cause more uncertainty or decisional conflict for patients: lack of knowledge about risks and benefits, poorly defined personal values about the importance of those risks and benefits, perception of a lack of support, unpredictable outcomes, or the impression that an inadequate decision has been made. Read More

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http://dx.doi.org/10.1503.cjs.003217DOI Listing
March 2019
3 Reads

Surgical outcomes of chronic isolated scapholunate interosseous ligament injuries: a systematic review of 805 wrists

Can J Surg 2019 Mar 22;62(3):1-12. Epub 2019 Mar 22.

From the University of Calgary, Calgary, Alta.

Background: Management of chronic isolated scapholunate interosseous ligament (SLIL) injuries has generated a substantial volume of low-quality literature with descriptions of multiple new surgical techniques, and the impact of instability pattern and the optimal surgical technique remain unclear. The primary goal of this review was to compare clinical, radiographic and patient-rated outcomes between current surgical techniques.

Methods: We performed a systematic literature search using multiple databases. Read More

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http://dx.doi.org/10.1503/cjs.006918DOI Listing

Development of a cumulative teaching score for tracking surgeon performance in undergraduate medical education

Can J Surg 2019 Mar 22;62(3):1-7. Epub 2019 Mar 22.

From the Department of Surgery, University of Toronto Faculty of Medicine, Toronto, Ont.

Background: Surgeon educators are important in undergraduate medical education (UME). However, teaching activities are undervalued and under-recognized compared with research, resulting in poorer quantity and quality of surgeon teaching. The purpose of this study was to investigate teaching roles available to surgeons and the amount of effort involved. Read More

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http://dx.doi.org/10.1503/cjs.009516DOI Listing

The impact of surgical modality on self-reported body image, quality of life and survivorship after anterior resection for colorectal cancer – a mixed methods study

Can J Surg 2019 Mar 22;62(3):1-8. Epub 2019 Mar 22.

From the Department of Surgery, University of Toronto, Toronto, Ont. (Hirpara, Azin); the Division of General Surgery, University Health Network, Toronto, Ont. (Mulcahy, O’Brien, Chadi, Quereshy); and the Faculty of Medicine, University of Toronto, Toronto, Ont. (Le Souder).

Background: There is growing enthusiasm for robotic and transanal surgery as an alternative to open or laparoscopic surgery for colorectal cancer (CRC). We examined the impact of surgical modality on body image and quality of life (QOL) in patients receiving anterior resection for CRC.

Methods: We used a mixed-methods approach, consisting of a chart review and semistructured interviews with CRC patients, at least 8 months after surgery. Read More

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http://dx.doi.org/10.1503/cjs.014717DOI Listing

Short stay total joint arthroplasty program: patient factors predicting readmission

Can J Surg 2019 03 22;62(3):1-7. Epub 2019 Mar 22.

From the Department of Surgery, Kingston Health Sciences Centre, Queens University, Kingston, Ont.

Background: The aim of this study was to evaluate the effectiveness of our short stay arthroplasty program as measured by 30-day readmission rate and the rate of transfer to inpatient care. Risk factors for readmission/transfer were also evaluated and contrasted with current patient screening criteria.

Methods: We retrospectively reviewed 297 charts for all primary total joint arthroplasties completed in the short stay program during an 18-month period. Read More

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http://dx.doi.org/10.1503/cjs.009218DOI Listing

Effect of the Trauma Evaluation and Management module on the knowledge of senior medical students: a prospective cohort study

Can J Surg 2019 Mar 22;62(3):1-5. Epub 2019 Mar 22.

From the Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Yahya); the Center of Excellence in Trauma and Accidents, King Abdulaziz University, Jeddah, Saudi Arabia (Yahya); the Clinical Skills and Simulation Center, King Abdulaziz University, Jeddah, Saudi Arabia (Yahya); the Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Ahmed, Mohammed, Marwan); and the Department of Family and Community Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Moniem).

Background: Despite the high incidence of motor vehicle collisions and associated mortality rates in Saudi Arabia, formal trauma training and management for undergraduate medical students is not optimal. The aim of our study was to assess the effect of the Trauma Evaluation and Management (TEAM) module on trauma knowledge among senior medical students.

Methods: Final-year medical students were recruited between September 2016 and May 2017 at King Abdulaziz University, Jeddah. Read More

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http://dx.doi.org/10.1503/cjs.018517DOI Listing

Variability among Canadian pediatric surgeons and pediatric urologists in the management of cryptorchidism in boys before the publication of major guidelines: a retrospective review of a single tertiary centre

Can J Surg 2019 Mar 22;62(3):1-6. Epub 2019 Mar 22.

From the Faculty of Medicine, University of Toronto, Toronto, Ont. (Kim, Lee); the Division of Urology, The Hospital for Sick Children, Toronto, Ont. (Kim, Chua, Ming, Lee, Kesavan, Kahn, Lorenzo, Bagli, Farhat, Papanikolaou, Koyle); the School of Medicine, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland (Kesavan); the Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ont., (Langer); and the Department of Surgery, University of Toronto, Toronto, Ont. (Langer, Lorenzo, Bagli, Farhat, Papanikolaou, Koyle).

Background: Before 2014, there was a lack of recommendations on managing cryptorchidism, or undescended testis (UDT), from a large pediatric urological or surgical organization. We assessed the variability in management of UDT among pediatric urologists and pediatric surgeons at a single tertiary pediatric referral centre before publication of major guidelines.

Methods: We performed a retrospective review of the electronic records of patients who underwent primary unilateral or bilateral orchidopexy at our centre between January 2012 and January 2014. Read More

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http://dx.doi.org/10.1503/cjs.014017DOI Listing
March 2019
1 Read

Complex abdominal wall hernias as a barrier to quality of life in cancer survivors

Can J Surg 2019 Mar 22;62(3):1-7. Epub 2019 Mar 22.

From the Department of Surgery, McMaster University, and St. Joseph’s Healthcare Hamilton, Hamilton, Ont. (Nenshi); Ethics and Professional Affairs, Canadian Medical Association, and the Joint Centre for Bioethics, University of Toronto, Toronto, Ont. (Bensimon); the Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Wood, Wright, Smith, Brenneman); and the Division of General Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (Wright, Smith, Brenneman).

Background: Many cancer survivors live with postoperative complex abdominal wall hernias (CAWHs). However, the impact of CAWHs on their quality of life is unknown, and few descriptions of patient experiences exist. We performed a qualitative study to explore cancer survivors’ experience with CAWHs before and after repair. Read More

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http://dx.doi.org/10.1503/cjs.014917DOI Listing
March 2019
2 Reads

Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centre

Can J Surg 2019 04;62(2):83-92

From the Department of Surgery, McMaster University, Hamilton, Ont. (Li, Cornacchi, Farrokhyar, Forbes, Reid, Hodgson, Lucibello, Lovrics); the Department of Surgical Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, Ont. (Forbes, Rid, Hodgson, Lovrics); the Department of Surgery, St. Joseph’s Healthcare, Hamilton, Ont. (Lovrics); and the Department of Medicine, McMaster University, Hamilton, Ont. (Johnston).

Background: Studies have shown an association between socioeconomic status and breast cancer treatment. We examined the relation between socioeconomic status and the treatment of breast cancer (surgical, systemic and radiation) in a universal health care system.

Methods: Data from a single urban Canadian centre were collected for consecutive patients who received a diagnosis of breast cancer from January 2010 to December 2011. Read More

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http://dx.doi.org/10.1503/cjs.009217DOI Listing

Limberg flap versus Karydakis flap for treating pilonidal sinus disease: a systematic review and meta-analysis

Can J Surg 2019 04;62(2):131-138

From the Department of General and Colorectal Surgery, Diana, Princess of Wales Hospital, Northern Lincolnshire and Goole, Grimsby, UK.

Background: The Limberg flap reconstruction and the Karydakis flap reconstruction are the 2 most used off-midline closure techniques in pilonidal sinus surgery. The current evidence is inconclusive as to which is the optimal technique. The aim of this systematic review and meta-analysis was to compare differences in outcomes between these 2 flap-based techniques. Read More

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http://dx.doi.org/10.1503/cjs.003018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440894PMC
April 2019
6 Reads

Use of the Corail stem for revision total hip arthroplasty: evaluation of clinical outcomes and cost

Can J Surg 2019 04;62(2):78-82

From the Division of Orthopaedic Surgery, Department of Surgery, London Health Sciences Centre, University Campus, Western University, London, Ont. (Wood, Alzahrani, Vasarhelyi, Lanting); the Department of Orthopaedic Surgery, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (Alzahrani); the School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ont. (Marsh); and the Bone and Joint Institute, Western University, London, Ont. (Marsh, Vasarhelyi, Lanting).

Background: With the growing number of total hip arthroplasty (THA) procedures performed, revision surgery is also proportionately increasing, resulting in greater health care expenditures. The purpose of this study was to assess clinical outcomes and cost when using a collared, fully hydroxyapatite-coated primary femoral stem for revision THA compared to commonly used revision femoral stems.

Methods: We retrospectively identified patients who underwent revision THA with a primary stem between 2011 and 2016 and matched them on demographic variables and reason for revision to a similar cohort who underwent revision THA. Read More

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http://dx.doi.org/10.1503/cjs.002318DOI Listing
April 2019
1 Read

Phyllodes tumour of the breast and margins: How much is enough

Can J Surg 2019 Feb;62(1`):E19-E21

From the Department of General Surgery, University of Toronto, Toronto, Ont.

Summary: Phyllodes breast tumours are fairly uncommon, and they can be benign, borderline or malignant. General surgeons usually encounter them following the surgical excision of a breast lump that had the appearance of a fibroepithelial lesion. The surgeon is then faced with the question of what to do to establish an acceptable treatment margin. Read More

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http://canjsurg.ca/vol62-issue1/62-1-E19/
Publisher Site
http://dx.doi.org/10.1503/cjs.005718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351251PMC
February 2019
3 Reads

Expanding the trauma code to other causes of hemorrhagic shock — ruptured abdominal aortic aneurysms

Can J Surg 2019 Feb;62(1):E17-E18

From the Division of Vascular and Endovascular Surgery, The Ottawa Hospital, Ottawa, Ont. (Chehroudi, Jetty); and the Division of General Surgery, The Ottawa Hospital, Ottawa, Ont. (Lampron).

Summary: Expediting life-saving care for hemorrhagic shock through multi-disciplinary code protocols is a potential method to improve outcomes. Trauma codes have become standard of care at most tertiary care centres; however, it is unclear if similar protocols can improve delivery of care for other forms of hemorrhagic shock. We examined the feasibility of a code protocol for ruptured abdominal aortic aneurysms (RAAAs) by reviewing the literature and comparing patient outcomes for RAAA and trauma patients at our institution, where the latter have a wellestablished trauma code protocol. Read More

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http://dx.doi.org/10.1503/cjs.018717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351263PMC
February 2019
1 Read

The importance of costing perspective: an example evaluating the cost-effectiveness of a locking versus nonlocking plate in medial opening wedge high tibial osteotomy

Can J Surg 2019 Feb;62(1):E14-E16

Summary: High tibial osteotomy (HTO) fixation can be achieved using various plate designs. Compared with nonlocking plates, the stability of locking plates allows patients to return to weight-bearing and work sooner and may also decrease postoperative complications, introducing the potential for overall cost savings. However, material costs for locking plates are higher, and the plate bulkiness may lead to additional surgery to remove the plate. Read More

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http://dx.doi.org/10.1503/cjs.018317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351264PMC
February 2019

Evaluation of common suturing techniques to secure implantable cardiac electronic device leads: Which strategy best reduces the lead dislodgement risk?

Can J Surg 2019 Feb;62(1):E7-

From the Libin Cardiovascular Institute of Alberta, Department of Cardiac Sciences, University of Calgary, Calgary, Alta. (Rezazadeh, Rizkallah); and the Division of Electrophysiology, Saint John Regional Hospital, Saint John, NB (Wang).

Summary: Implantable cardiac electronic device lead dislodgment is a relatively common complication and carries significant comorbidities. A potential cause of lead dislodgement includes inadequate anchoring along the lead suture sleeve at the venous insertion site. We assessed which of the 3 commonly applied knot-tying techniques results in the most effective anchoring of a pacing lead along its suture sleeve, which could be associated with minimized lead motion postimplant. Read More

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http://dx.doi.org/10.1503/cjs.002418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351253PMC
February 2019

How well do we do what we do, and how do we know it? The importance of patient-reported experience measures in assessing our patients’ experience of care

Authors:
Duncan Rozario

Can J Surg 2019 Feb;62(1):E7-E9

From the Department of Surgery, Oakville Trafalgar Memorial Hospital, Oakville, Ont.

Summary: As highly trained practitioners in the practice of patient care, at times we may not emphasize the art of the patient experience. Multiple studies have shown that patients’ attitudes and expectations have an effect on their outcomes after surgery. Our patients’ perceptions of their care, through proxies like respect, courtesy, compassion, emotional connection and listening, may be as important to them as the actual care received. Read More

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http://canjsurg.ca/vol62-issue1/62-1-E7/
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http://dx.doi.org/10.1503/cjs.006618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351267PMC
February 2019
1 Read

Can we improve the efficiency of care in patients with colorectal cancer from the time of their initial referral for colonoscopy to surgical resection?

Can J Surg 2019 Feb;62(1):E4-E6

From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Kloos, Keren, Gregg, Dixon, Rochon, Ball); and the Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB (Mohamed).

Summary: Delays in the diagnosis and treatment of colon adenocarcinoma are distressing to patients and clinicians alike. Of 224 patients with resected colon cancer identified via a province-wide administrative database, 170 (76%) received their colonoscopy from a gastroenterologist (GI). Patients waited significantly longer between their colonoscopy and surgical resection when the colonoscopy was performed by a GI within an urban city (43 v. Read More

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http://canjsurg.ca/vol62-issue1/62-1-E4/
Publisher Site
http://dx.doi.org/10.1503/cjs.008818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351269PMC
February 2019
4 Reads

Author response to “Breast reconstruction: no need to ‘break new ground’”

Authors:
Lashan Peiris

Can J Surg 2019 Feb;62(1):E2-E3

From the Department of General Surgery, Misericordia Community Hospital, Edmonton, Alta.

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http://dx.doi.org/10.1503/cjs.1962102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351259PMC
February 2019

Breast reconstruction: no need to “break new ground”

Authors:
Douglas Ross

Can J Surg 2019 Feb;62(1):E1-E2

Chair, Division of Plastic Surgery, Western University, London, Ont.

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http://dx.doi.org/10.1503/cjs.1962101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351250PMC
February 2019

Utility of the Vascular Quality Initiative in improving quality of care in Canadian patients undergoing vascular surgery

Can J Surg 2019 Feb;62(1):66-69

From the Faculty of Medicine, University of Toronto, Toronto, Ont. (Liao); the Division of Vascular Surgery, University Health Network, Toronto, Ont. (Eisenberg, Roche-Nagle); the Faculty of Medicine, University of Edinburgh, Edinburgh, Scotland (Kaushal); the Pain Research Unit, Department of Anesthesia and Pain Management, University Health Network (Montbriand); and the Division of Vascular and Interventional Radiology, University Health Network, Toronto, Ont. (Tan, Roche-Nagle).

The Vascular Quality Initiative (VQI) is a national cooperative quality-improvement initiative designed to evaluate processes of care and outcomes in vascular surgery. The purpose of this report is to show the utility of such a database to provide insight into the standard of care provided, to highlight areas of local quality improvement, to benchmark our data against local, regional and national trends, and to ultimately improve safety in Canadian patients undergoing vascular surgery. We present the history of the database, its spread in the Canadian health care system and examples of quality improvements achieved from analyses of data recorded and retrieved from the VQI. Read More

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http://dx.doi.org/10.1503/cjs.002218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351256PMC
February 2019

Understanding the patellofemoral joint in total knee arthroplasty

Can J Surg 2019 02;62(1):57-65

From the Division of Orthopedic Surgery, London Health Sciences Centre, London, Ont. (Matz, Lanting, Howard).

Total knee arthroplasty (TKA) is one of the most successful procedures in orthopedic surgery. Nevertheless, postoperative patellofemoral complications remain a challenging problem, affecting a substantial proportion of patients. Complications involving the patellofemoral joint (PFJ) can occur in both resurfaced and nonresurfaced patellae. Read More

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http://dx.doi.org/10.1503/cjs.001617DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351265PMC
February 2019
8 Reads

Clinical outcomes of single-incision robotic cholecystectomy versus conventional 3-port laparoscopic cholecystectomy

Can J Surg 2019 Feb;62(1):52-56

From the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Few studies have compared the surgical results of single-incision robotic cholecystectomy (SIRC) with those of conventional laparoscopic cholecystectomy (CLC). The purpose of this study was to evaluate the relative clinical efficacy of SIRC by comparing the number of postoperative days, pain level and complications between the 2 surgical methods.

Methods: We retrospectively collected demographic, perioperative and postoperative data for all patients who underwent SIRC or CLC performed by a single surgeon from June 2016 to May 2017. Read More

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http://dx.doi.org/10.1503/cjs.000118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351249PMC
February 2019
1 Read

Quantifying recall bias in surgical safety: a need for a modern approach to morbidity and mortality reviews

Can J Surg 2019 Feb;62(1):39-43

From the International Centre for Surgical Safety, St. Michael’s Hospital, Toronto, Ont. (Alsubaie, Goldenberg, Grantcharov).

Background: Despite recent investments into reducing errors and adverse events in health care, methods for quality improvement in surgery are outdated and ineffective. Most current efforts in this field are centred around morbidity and mortality conferences (MMCs), which have remained unchanged for over 100 years. The present study aimed to quantify the recall bias associated with details from surgical cases. Read More

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http://dx.doi.org/10.1503/cjs.017317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351262PMC
February 2019

Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study

Can J Surg 2019 Feb;62(1):33-38

From the Department of Surgery, University of Alberta, Edmonton, Alta. (Saravana-Bawan, Warkentin, Churchill, Khadaroo); the Division of Geriatrics, Department of Medicine, University of Alberta, Edmonton, Alta. (Rucker, Carr); and the Department of Critical Care Medicine, University of Alberta, Edmonton, Alta. (Khadaroo).

Background: Among older inpatients, the highest incidence of delirium is within the surgical population. Limited data are available regarding postoperative delirium risk in the acute care surgical population. The purpose of our study was to establish the incidence of and risk factors for delirium in an older acute care surgery population. Read More

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http://dx.doi.org/10.1503/cjs.016817DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351261PMC
February 2019
2 Reads

Impact of sequential implementation of multimodal perioperative care pathways on colorectal surgical outcomes

Can J Surg 2019 Feb;62(1):25-32

From the Faculty of Medicine, University of British Columbia, Vancouver, BC (D’Souza, Choi, Wallace); the Interior Health Authority Quality, Risk, and Accreditation, Royal Inland Hospital, Kamloops, BC (Wootton, Wallace); and the Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, BC (Wallace).

Background: Standardized care protocols offer the potential to reduce postoperative complication rates. The purpose of this study was to determine whether there was an additive benefit associated with the sequential implementation of the evidence-based surgical site infection bundle (SSIB) and enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery in a community hospital.

Methods: Patients at a single institution who underwent elective colorectal surgery between Apr. Read More

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http://dx.doi.org/10.1503/cjs.015617DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351254PMC
February 2019
1 Read

Reinventing the wheel in scoliosis surgery: effective strategies for safely improving efficiency

Can J Surg 2019 Feb;62(1):7-8

From the Cumming School of Medicine, University of Calgary, Calgary, Alta; and the Department of Surgery, Division of Pediatric Orthopedic Surgery, Alberta Children’s Hospital, Calgary, Alta.

Posterior spinal instrumentation and fusion (PSIF) has been the standard operative treatment for adolescent idiopathic scoliosis (AIS) and is one of the most frequently performed elective pediatric surgeries in North America, incurring an expenditure of more than $1.1 billion annually in the United States alone. This commentary reflects on the outcomes of systematically implementing intraoperative skull femoral traction (IOSFT) combined with navigated sequential drilling (NSD) during PSIF for AIS as strategies for quality improvement at our tertiary children’s hospital. Read More

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http://dx.doi.org/10.1503/cjs.019317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351258PMC
February 2019
1 Read

Ne pas passer sous silence l’épidémie de burn-out

Authors:
Edward J. Harvey

Can J Surg 2019 Feb;62(1):5-6

Corédacteur en chef, Journal canadien de chirurgie

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http://dx.doi.org/10.1503/cjs.000919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351257PMC
February 2019
1.267 Impact Factor

Burnout should not be a silent epidemic

Authors:
Edward J. Harvey

Can J Surg 2019 Feb;62(1):4-5

Coeditor, Canadian Journal of Surgery

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http://dx.doi.org/10.1503/cjs.000819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351260PMC
February 2019
1.267 Impact Factor

Can we reduce ischemic cholangiopathy rates in donation after cardiac death liver transplantation after 10 years of practice? Canadian single-centre experience

Can J Surg 2019 02;62(1):44-51

From the Multi-Organ Transplant Program, London Health Sciences Centre, London, Ont. (Tun-Abraham, Wanis, GarciaOchoa, Sela, Sharma, Quan, Hernandez-Alejandro); the Division of Transplantation, Prince Sultan Military Medical City, Riyadh, Saudi Arabia (Al Hasan); and the Division of Solid Organ Transplantation, University of Rochester, Rochester, NY (Al-Judaibi, Levstik, Hernandez-Alejandro).

Background: Outcomes in liver transplantation with organs obtained via donation after cardiocirculatory death (DCD) have been suboptimal compared to donation after brain death, attributed mainly to the high incidence of ischemic cholangiopathy (IC). We evaluated the effect of a 10-year learning curve on IC rates among DCD liver graft recipients at a single centre.

Methods: We analyzed all DCD liver transplantation procedures from July 2006 to July 2016. Read More

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http://dx.doi.org/10.503/cjs.012017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351268PMC
February 2019
16 Reads

Understanding the surgical care needs and use of outpatient surgical care services among homeless patients at the Ottawa Hospital

Can J Surg 2018 12;61(6):424-429

From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Zuccaro, Champion, Bennett, Ying); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Champion, Bennett, Ying); and the Children’s Hospital of Eastern Ontario and The Ottawa Hospital, Ottawa, Ont. (Ying).

Background: The use of outpatient health care services by homeless people is low compared to their high level of need; however, it is unclear whether this applies to surgical care. We sought to describe surgical care access among homeless patients in a Canadian tertiary care setting.

Methods: We reviewed the medical records of adult (age > 18 yr) patients with no fixed address or a shelter address who presented to The Ottawa Hospital Emergency Department from Jan. Read More

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http://dx.doi.org/10.1503/cjs.001317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281449PMC
December 2018
13 Reads

After the war is over: the role of General Sir Arthur Currie in the development of academic medicine in Canada

Can J Surg 2018 12;61(6):367-369

From Western University, London, Ont. (Hyatt, McAlister); McGill University, Montreal, Que. (Beckett); and the Royal Canadian Medical Services, (Beckett, McAlister).

Summary: Canadian universities faced a challenge with the return of a large cohort of battle-hardened students and faculty from the First World War. General Sir Arthur Currie, considered one of the few successful generals of the war, returned to a welcome of silence in Canada. McGill University exploited the opportunity to recruit him as its president. Read More

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http://dx.doi.org/10.1503/cjs.017118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281458PMC
December 2018

Tyranny of the pain score question after surgery

Can J Surg 2018 12;61(6):364-365

Coeditor, Canadian Journal of Surgery

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http://dx.doi.org/10.1503/cjs.017418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281452PMC
December 2018

Novel use of FaceTime video calling in a deployed setting to assist with the care of a military working dog

Can J Surg 2018 12;61(6):S232-S234

From the Carl R. Darnall Army Medical Center, Department of Emergency Medicine, Medical Corps, United States Army, Fort Hood, TX (Donham); and the University of Toronto, Toronto, Ont. (Wickett).

Summary: In deployed settings, veterinary recourses are limited and nonveterinary medical providers frequently are required to provide medical treatment to military working dogs (MWDs) until veterinary specialty care can be provided. We present the case of a critically ill MWD who presented initially to a Canadian NATO Role II facility in Iraq that lacked immediate veterinary support. Through the use of FaceTime interactive video calling, the Role II medical providers were able to consult with the MWD unit’s veterinarian in the United States and provide effective evaluation, treatment and prioritization of medical evacuation (MEDEVAC). Read More

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http://dx.doi.org/10.1503/cjs.015118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281462PMC
December 2018

Reflections on recovery, rehabilitation and reintegration of injured service members and veterans from a bio-psychosocial-spiritual perspective

Can J Surg 2018 12;61(6):S219-S231

From the Canadian Forces Health Services (Besemann); the Division of Physical Medicine & Rehabilitation, University of Alberta, Edmonton, Alta. (Hebert); Veterans Affairs Canada, Charlottetown, PEI (Thompson); the US Department of Veterans Affairs, University of Pittsburgh, and UPMC Health System (Cooper); McGill University, Montreal, Que. (Gupta); the Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alta. (Brémault-Phillips); and the College of Medical Rehabilitation, Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Dentry).

Medical interventions regarding trauma resuscitation have increased survivorship to levels not previously attained. Multiple examples from recent conflicts illustrate the potential return to high-level function of severely injured service members following medical and rehabilitative interventions. This review addresses the goals of rehabilitation, distills hard-won lessons of the last decade of military trauma and rehabilitation, and recommends the use of a bio-psychosocial-spiritual approach to care that can be applied at all tiers of the health care system. Read More

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http://dx.doi.org/10.1503/cjs.015318DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281470PMC
December 2018
1 Read

The effect of aerosolized indomethacin on lung inflammation and injury in a rat model of blunt chest trauma

Can J Surg 2018 12;61(6):S208-S218

From the Department of National Defense, Royal Canadian Medical Services, Ottawa, Ont. (Kao); Critical Care Western, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Kao, Martin, Rui); and the Centre for Critical Illness Research, Lawson Health Research Institute, London, Ont. (Kao, Martin, Rui).

Background: Acute lung contusion from blunt chest trauma (BCT) is characterized by an intense inflammatory response in the pulmonary parenchyma, which is associated with acute lung injury (ALI), acute respiratory distress syndrome and ventilator-associated pneumonia. We hypothesized that aerosolized indomethacin may reduce pulmonary inflammation and ALI in a rat model of BCT.

Methods: Sprague-Dawley rats were anesthetized and received a tracheotomy for administration of aerosolized medication through a catheter. Read More

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http://dx.doi.org/10.1503/cjs.014318DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281466PMC
December 2018
4 Reads

Impact of traumatic upper-extremity amputation on the outcome of injury caused by an antipersonnel improvised explosive device

Can J Surg 2018 12;61(6):S203-S207

From the Royal Canadian Medical Service, Ottawa, Ont. (Smith, DaCambra, McAlister); and the Division of General Surgery, Western University, London, Ont. (Smith, McAlister).

Background: We have previously reported a higher than expected rate of upper-extremity amputation (UEA) in victims of an antipersonnel improvised explosive device (AP-IED) compared with a similar cohort injured by antipersonnel mines (APM). The goal of this study was to describe the rate, severity and impact of UAE caused by an AP-IED.

Methods: We analyzed a prospective database of 100 consecutive dismounted AP-IED victims with pattern 1 injuries to compare the outcomes of the cohort with UEA to that without. Read More

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http://dx.doi.org/10.1503/cjs.014518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281463PMC
December 2018
16 Reads

Utilization profile of the Canadian-led coalition Role 2 Medical Treatment Facility in Iraq: the growing requirement for multinational interoperability

Can J Surg 2018 12;61(6):S195-S202

From the Royal Canadian Medical Service, Canadian Armed Forces (DaCambra, Kao, Berger, McAlister); the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (DaCambra); the Division of Internal Medicine and Critical Care, Western University, London, Ont. (Kao); the Department of Anesthesia, Dalhousie University, Halifax, NS (Berger); and the Division of General Surgery, Western University, London, Ont. (McAlister).

Background: The Canadian Armed Forces deployed a Role 2 Medical Treatment Facility (R2MTF) to Iraq in November 2016 as part of Operation IMPACT. We compared the multinational interoperability required of this R2MTF with that of similar facilities previously deployed by Canada or other nations.

Methods: We reviewed data (Nov. Read More

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http://dx.doi.org/10.1503/cjs.015218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281465PMC
December 2018